Nassar's letter was written before the sentencing hearing and victim-impact statements occurred this week. The statements have been ongoing with over 50 victims speaking in court as of this writing and another 50 more at least are expected.

The letter was read aloud in court by Judge Aquilina and included the following passages.

"I'm very concerned about my ability to be able to face witnesses this next four days mentally."

"Aquilina said if I pass out she'll have the EMTs revive me and then prop me up in the witness box."

"She wants me to sit in the witness box next to her for all four days so the media cameras will be directed toward her."

Nassar did faint twice during federal sentencing according to reports.

After the reading Aquilina addressed Nassar directly for about 10 minutes, saying in part:

"You may find it harsh that you are here listening. But nothing is as harsh than what your victims endured for thousands of hours at your hands... spending four or five days listening to them is significantly minor considering the hours of pleasure you’ve had at their expense and ruining their lives... this isn’t worth the paper it’s written on, there’s no truth in there, it’s delusional".

Nassar agreed to the victim-impact hearings as part of his plea deal. Victim-impact statements are expected to go on until at least Friday and possibly into next week.